Anatomy and Physiology XXVI

Question 1

What signs/ symptoms are present in open/wide angle glaucoma?

Answer 1

Painless, peripheral then central vision loss usually with increased IOP. Optic disk atrophy with cupping occurs (p.439)

Question 2

What conditions are associated with open/ wide angle glaucoma?

Answer 2

Increased age, african american race, family history, elevated IOP (p.439)

Question 3

What type of glaucoma is most common in the US?

Answer 3

Open/ Wide angle glaucoma (p.439)

Question 4

What are the primary and secondary causes of open/wide angle glaucoma?

Answer 4

Primary cause is unclear; secondary causes include uveitis, trauma, corticosteroids, and vasoproliferative retinopathy that can block or decrease outflow at the trabecular meshwork (p.439)

Question 5

What is closed/ narrow angle glaucoma?

Answer 5

Enlargement or forward movement of the lens against the central iris leads to obstruction of normal aqueous flow through the pupil. This causes fluid buildup behind the iris, pushing the peripheral iris agains the cornea and impeding flow through the trabecular network (p.439)

Question 6

What are the two forms of closed/narrow angle glaucoma?

Answer 6

Chronic closure and acute closure (p.439)

Question 7

What is chronic closure closed/ narrow angle glaucoma?

Answer 7

Usually asymptomatic closed/ narrow angle glaucoma with damage to the optic nerve and peripheral vision (p.439)

Question 8

What is acute closure closed/narrow angle glaucoma?

Answer 8

A true opthalmic emergency where increased IOP pushes the iris forwards closing the angle abruptly (p.439)

Question 9

What symptoms are characteristic of acute closure closed/ narrow angle glaucoma?

Answer 9

Very painful, sudden vision loss, halos around lights, rock-hard eye, frontal headache (p.439)

Question 10

What drug is contraindicated in suspected acute closure closed/narrow angle glaucoma and why?

Answer 10

Epinephrine due to its mydriatic effect (p.439)

Question 11

What is the primary difference between acute and chronic closed/narrow angle glaucoma?

Answer 11

Acute is an opthalamic emergency and is very painful; chronic is typically painless and is not emergent (p.439)

Question 12

What are cataracts?

Answer 12

Painless, often bilateral opacification of the lens causing a decrease in vision (p.439)

Question 13

Name 10 risk factors for cataracts.

Answer 13

Age, smoking, EtOH, excessive sunlight, prolonged corticosteroid use, classic galactosemia, galactokinase deficiency, diabetes (sorbitol), trauma, infection (p.439)

Question 14

What is papilledema?

Answer 14

Optic disk swelling (usually bilateral) due to increased intracranial pressure (p.439)

Question 15

What findings are noted on fundoscopic exam in a patient with papilledema?

Answer 15

An enlarged blind spot and elevated optic disk with blurred margins (p.439)

Question 16

What cranial nerve innervates the lateral rectus muscle?

Answer 16

CN VI (p.439)

Question 17

What cranial nerve innervates the superior oblique muscle?

Answer 17

CN IV (p.439)

Question 18

To what extraoccular muscle does the trochlea attach/ activate?

Answer 18

Superior oblique muscle (p.439)

Question 19

Name the six extraoccular muscles.

Answer 19

Superior Oblique, Inferior oblique, Medial Rectus, Lateral Rectus, Superior Rectus, Inferior Rectus (p.439)

Question 20

When adducted, the superior oblique muscle moves in what directions?

Answer 20

It abducts, intorts, and depresses (p.439)

Question 21

What signs and symptoms are associated with CN III damage?

Answer 21

The eye looks down and out; ptosis, pupillary dilation, loss of accomodation (p.439)

Question 22

What signs and symptoms are associated with CN IV damage?

Answer 22

The eye moves upwards, particularly with contralateral gaze and ipsilateral head tilt (p.439)

Question 23

What signs and symptoms are associated with CN VI damage?

Answer 23

Medially directed eye that cannot abduct (p.439)

Question 24

A patient with CN IV damage typically reports problems doing what?

Answer 24

Going down stairs (p.439)

Question 25

To test the function of the superior rectus muscle, how do you direct the patient to move his/her eye?

Answer 25

Have the patient try to look up from the abducted position (p.440)